2000—2018年我国城乡居民医疗保健支出公平性变化研究

Research on the Changes of Equity in Medical Care Expenditure between Urban And Rural Areas in China from 2000 to 2018

目的:了解我国城乡及地区间医疗保健支出现状及差异性,分析我国城乡居民医疗保健支出的公平性,为我国医药卫生体制改革提供科学参考。方法:收集2000—2018年城乡医疗保健支出、人均可支配收入及人均纯收入等相关数据,采用集中指数和集中曲线对我国城乡医疗保健支出进行公平性分析。结果:2010—2018年城镇居民人均医疗保健支出(实际值)年平均增长速度为3.55%,农村居民人均医疗保健支出(实际值)年平均增长速度为10.00%。2000—2017年我国城镇居民人均医疗保健支出集中指数呈下降趋势,其中2006年出现最大值为0.1332,除2015—2017年外,其余年份差异均具有统计学意义(P<0.05);2000—2017年我国农村居民人均医疗保健支出集中指数呈下降趋势,2004年出现最大值为0.2522,差异均具有统计学意义(P<0.05)。结论:我国城乡人均医疗保健支出逐年增加,全国和各地区城乡人均医疗保健支出差距较大。我国城乡人均医疗保健支出存在不公平性,城镇人均医疗保健支出优于农村人均医疗保健支出,公平性逐渐趋好。

Objective:In order to measure the current situation and differences of medical and health expenditure between urban and rural areas and regions in China,it analyzes the equity of health care expenditure between urban and rural residents in China,and provide scientific references for the reform of China’s medical and health system reform.Methods:The urban and rural health expenditure,per capita disposable income and per capita net income of the related data from 2000 to 2018 are collected to conduct the equity analysis on the urban and rural health care expenditure based on the concentration index and the concentration curve.Results:From 2010 to 2018,the average annual growth rate of urban residents’per capita health care expenditure(real value)is 3.55%,and the average annual growth rate of rural residents’per capita health care expenditure(real value)is 10.00%.From 2000 to 2017,the concentration index of per capita medical care expenditure of urban residents in China shows a decreasing trend,among which the maximum value is 0.1332 in 2006.In addition to the 2015—2017,with statistically significant differences(P<0.05).From 2000 to 2017,the concentration index of per capita medical care expenditure of rural residents in China shows a decreasing trend,and the maximum value is 0.2522 in 2004,with statistically significant differences(P<0.05).Conclusion:The per capita expenditure on health care in urban and rural areas increases year by year,and there is a big gap between urban and rural areas and regions.China’s per capita medical and health care expenditure in urban and rural areas are not fair.Urban per capita medical and health care expenditure are better than rural per capita medical and health care expenditure,and the equity is gradually getting better.